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General NPI Number Information
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NPI Number | 1942024351
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Entity Type | Organization
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Legal Business Name | TLCGIVERS
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 1061 MONROE ST
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City | SANTA CLARA
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State | CA
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Zip | 95050-4810
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Country | US
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Telephone | 408-869-0022
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Fax |
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Provider Business Mailing Address
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Address Line | 1061 MONROE ST
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City | SANTA CLARA
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State | CA
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Zip | 95050-4810
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Country | US
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Telephone | 408-869-0022
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Fax |
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Authorized Official
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Title or Position | CO OWNER
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Name | WILFRED MABANTA
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Credential |
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Telephone | 408-869-0022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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